In the simplest terms, obesity is the product of a body’s energy output being less than its energy input. But in reality there is nothing simple about this complex and mysterious disease.
Obesity, which has skyrocketed in recent decades – now defining the body weight of more than 40 percent of adult Americans – isn’t just hard for humans to tolerate and for scientists to understand. It’s also incredibly difficult to treat.
Besides a commitment to sustainable lifestyle changes – effective healthy eating and exercise – there are really only two possible options that can help: bariatric surgery and weight loss medications.
The first is invasive and carries various risks and complications. As for the drugs, they don’t always work and can have their own adverse effects as well.
However, an experimental treatment recently tried by scientists and detailed in a study published this week could open new doors for the treatment of obesity patients with a weight-loss drug.
In the study, which involved nearly 2,000 obese adults in 16 different countries, participants took a weekly dose of a drug called semaglutide, an existing drug already used in the treatment of type 2 diabetes.
A control group only took a placebo instead of the medication. Both groups received a lifestyle intervention course to promote weight loss.
At the end of the trial, the participants taking the placebo lost a small but clinically insignificant amount of weight. But for those taking semaglutide, the effects were pronounced.
After 68 weeks of treatment with the drug – which suppresses appetite due to a variety of effects on the brain – participants taking semaglutide lost an average of 14.9 percent of their body weight. And more than 30 percent of the group lost more than 20 percent of their body weight.
Broadly speaking, this makes the drug up to twice as effective as existing weight loss drugs, the researchers say, close to the sort of efficacy of surgical procedures.
“No other drug has reached this level of weight loss – this is truly a game changer,” said University College London obesity researcher Rachel Batterham.
“For the first time, people with drugs can achieve what was only possible through weight loss surgery.”
In addition to weight loss, participants noted improvements in other areas, showed decreases in various cardiometabolic risk factors, and reported improvements in quality of life.
While the results are compelling, semaglutide dosage for anti-obesity effects has some drawbacks.
Mild to moderate effects were reported by many participants (both in the semaglutide and placebo groups), including nausea and diarrhea. Although the effects were temporary, they were enough for nearly 60 participants to discontinue their treatment, compared with just five in the placebo group.
Currently, the drug requires a weekly injection to work – while an oral form of the drug would likely be preferred by patients.
Most importantly, we don’t yet have any data on what happened to the participants after the drug regimen was stopped at the end of the trial.
But for at least one person who has spoken The New York Times, her weight began to creep up after the process was over.
“While these types of drugs may be useful in the short term for rapid weight loss in severe obesity, they are not a panacea for preventing or treating less severe obesity,” said nutritionist Tom Sanders, professor emeritus at King’s College London. , who was not involved in the investigation.
“Public health measures that encourage behavioral changes, such as regular exercise and moderation of dietary energy intake, are still needed.”
No one will deny the wisdom of that, but if further analysis of semaglutide turns out to be positive, we could also look at an important new pharmaceutical option to help fight obesity.
And that option may come sooner than we think.
The study, funded by the pharmaceutical company Novo Nordisk – which sells semaglutide as an anti-diabetic – is now being submitted as evidence to international health regulatory authorities, in support of an application to market the drug as a treatment for obesity.
The US FDA, along with its UK and European counterparts, is currently reviewing the data.
The findings are reported in The New England Journal of Medicine.